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VERIFICATION OF ULTRASOUND AS THE PRIMARY DIAGNOSTIC INVESTIGATION FOR THE DETECTION OF FULL THICKNESS ROTATOR CUFF TEARS



Abstract

The purpose of this study is to ascertain the efficacy of ultrasound in determining pathology prior to surgical intervention for rotator cuff tears, 88 patients were referred for surgery on clinical grounds.

One Radiologist who is widely experienced in shoulder ultrasound scanned these patients within one month prior to their operation using up to date equipment. The patients were categorised into 2 groups: those with or those without a full thickness rotator cuff tear. The results were then verified using surgery as the ‘gold standard’. This enabled the researcher to calculate the diagnostic accuracy of the procedure.

The findings show that in this Trust, ultrasound has a sensitivity of 95% in the detection of full thickness rotator cuff tears. The specificity is 87%, positive predictive value 87% and negative predictive value 95%.

Knowledge of the cuff status prior to surgery aids in pre-operative patient counselling in terms of surgical procedure (arthroscopic or open surgery), rehabilitation and prognosis. This study demonstrates that expert practitioners can produce reliable results using ultrasound, which can then be used as the primary investigation for the detection of full thickness rotator cuff tears. More expensive procedures such as Magnetic Resonance imaging are now limited to those patients with equivocal ultrasound findings.

The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom